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1
Q

Some tumor cells can escape immune system surveillance by … (and example)

A

modulation –> ex: internalizing the surface antigen so that it no longer presents a target for immune attack

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2
Q

tumors and antibodies

A

Tumor antigens can stimulate the development of specific antibodies: a. some are cytotoxic, but others called a. blocking and enhance tumor growth (perhaps by blocking recognition of tumor antibodies by host)

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3
Q

T cell tolerance - central vs peripheral according to definition

A

central tolerance –> tolerance to self antigens within tha thymus
peripheral tolerance –> tolerance acquired outside the thymus

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4
Q

beside Thymus, AIRE also act at (where and why)

A

in the peripheral lymphoid organs (such as spleen and lymph nodes) where it contributes to peripheral tolerance

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5
Q

Peripheral tolerance is necessary because

A

some self antigens are not expressed in thymus

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6
Q

Clonal ingorance?

A

self reactive lymphocyte ignore self antigens (either by physical separation (ex. BBB,) or because self antigens are in small amount)

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7
Q

Clona anergy - the failure of constimulatory signal most often occurs when

A

is an insufficient inflammatory respomse at the site of infection

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8
Q

types of B-cell tolerance (and location)

A
  1. clonal deletion (bone marrow)

2. clonal anergy (periphery)

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9
Q

Whether an antigen will iduce tolerance rather than immunologic response:

A
  1. maturity of immun system of the host (neonatal do not respond well to foreign antigens
  2. structure and dose of antigen (simple molecules induce toleranc more rapidly, and very high or very low doses of antigens may result in tolerance)
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10
Q

insulin-resistant diabetes - antibodies against

A

insulin receptor

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11
Q

hypersensitivity reactions with antibodies (and which antibodies)

A

type I –> IgE
type II –> IgG or IgM
type III –> IgG

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12
Q

hypersensitivity reactions 1st vs subsequent contacts

A

the 1st contact of the individuals with the antigen sensitize, the subsequent elicit the allergic respond

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13
Q

hypersensitivity reaction type I - complement

A

not involved

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14
Q

Non allergic respond to allergens

A

produce IgG

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15
Q

which clinical manifestations occurs in hypersensitivity type 1 depends in

A
  1. the route of entry
  2. the location of the mast cells bearing IgE
    ex. (air –> hey fever, food –> diarrhe)
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16
Q

hypersensitivity reaction type 1 - disease according to rout of entry

A
  1. lung –> asthma
  2. nose and eyes –> rhinitis, conjunctivitis, hey fever
  3. skin –> eczema, urticaria
  4. intestinal tract –> allergic gastroenteropathy
  5. Systemic –> anaphylaxis
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17
Q

the MCCs of anaphylaxis

A
  1. food such as peanuts and shellfish
  2. bee venom
  3. drugs such as penicillin
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18
Q

atopic disorders exhibit strong familial predisposition and are associated with

A

elevated IgE levels

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19
Q

hypersensitivity reaction type 2 - antibodies

A

IgG or IgM

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20
Q

hypersensitivity reaction type 4 - cells

A
  1. Th
  2. macrophages
  3. T cytotoxic
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21
Q

Prozone phenomenon is a

A

false negative response resulting from high antibody titer which interferes with formation of antigen- antibody

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22
Q

the pathway that mostcommonly activate complement the first time that a person is exposed to a bug

A

lectin and alternative (because no antibody)

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23
Q

a complement regultion beside C1 esterase and DAF

A

regulation of alternative pathway is mediated by the binding of factor H to C3b and cleavage of this complex by factor I (a protease)

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24
Q

An extra role of C3b

A

binds to its receptor in the surface of activated B cells –> enhances antibodies in by the B cells that are activated alone

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25
Q

measles and CMC vs immune system (and examples)

A

they can suppress cell-mediated against other microorganisms
measles infection in people with TB –> PPD (-) (suppression of il-12 by macrophagea)

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26
Q

CMV, VZV, HSV-2, - latent in

A

CMV –> mononuclear cells
VZV –> dorsal root or trigemina ganglia
HSV-2 –> sacral ganglia

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27
Q

antibody - primary response

A

longer lag period –> 7 - 10 days (can be longer depending on the nature and dose of the antigen)
IgM

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28
Q

antibody - secondary response

A

IgM produced similar to the primary, but much larger amount of IgG is produced and tend to persist much longer

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29
Q

affinity maturation is the process by which

A

B cells produce antibodies with increased affinity for antigen during the course of an immune response

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30
Q

The first line of defence against microorganisms

A

intact skin and mucous membranes

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31
Q

innate humoral immunity

A

complement and neutrophils

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32
Q

antibodies in Th independent produced

A

only IgM because –> no IL-4,5 –> no class switch

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33
Q

immunity - age

A

less than optimal in newborn and elderly

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34
Q

Defesins?

A

highly positively charged peptides that create pores in the membranes of bacteria and thereby kill them

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35
Q

causes of high calcium-phosphate mediated metastatic calcification

A
  1. chronic renal failure with 2ry hyperparathyroidism
  2. long term dialysis
  3. calciphylaxis
  4. warfarin
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36
Q

causes of high calcium mediated metastatic calcification

A
  1. 1ry heperparathyroidism
  2. sarcoidosis
  3. hypervitaminosis D
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37
Q

CD54

A

ICAM-1

38
Q

CD55

A

DAF

39
Q

CD106

A

VCAM-1

40
Q

CD31

A

PECAM-1

41
Q

Free radicals injury is initiated by

A
  1. radiation exposure (eg. cancer therapy)
  2. metabolism of drugs (phase 1)
  3. REDOX
  4. Nitric oxide
  5. transition metals
  6. WBC oxidative burst
42
Q

CD95

A

Fas (receptor)

43
Q

B - cell immunodeficiency - live vaccines

A

contraindicated

44
Q

IgA transcytosis

A

IgA dimers bind to there polymeric immunoglobulin receptor (pIgR) found on the basolateral surface of intestinal epithelial cells + undegro trancytosis –> as they are released in the lumen, the pIgR stay attached

45
Q

xanthine oxidase deficiency

A

very low uric acid

- renal calculi due to insolubility of xanthine at urine pH

46
Q

Giardia lambila - histology of organism + of intestine

A

organism: pear shaped with multiple flagella + 2 nuclei (owl’s eues). The cysts contain up to 4 nuclei
intestine: villous atrophy, crypt hyperplasia

47
Q

cGMP has role in physiological process such as

A

SMCs relaxation + retinal phototransduction

48
Q

defected IFN-γ signaling pathway –> …..(manegment)

A

lifelong antimycobacterial agents

49
Q

PD1 role

A

Programmed death receptor (PD1) and its lignat downregulates the immune agaist tumor cells by inhibiting cytotoxic T cells. Many types of Cancer evade the immune system by increasing expression of PD1 ligant
Monoclonal antibodies agaist PD-1 help prevent T cell inhibition + promote apoptosis of tumor cells
CTLA-4 has a similar role –> bind + inhibit B7

50
Q

other chemotactic agents

A

n-formylated peptides

5-HETE

51
Q

protein that bind + inhibit B7

A

CTLA-4

52
Q

anaphylaxis - time to initiate

A
  • seconds to minutes after intravascular exposure (eg. IV medication , insect stings)
  • up to 2 hours with orally ingested antigens
53
Q

marker of Mast cells activation

A

tryptase

54
Q

binded IgE to mast cells –> bind to antigen –> …. (next step)

A

aggregation of receptors -> non-receptor tyrosine kinase –> degranulation + release

55
Q

examples of receptor internalization

A
  1. excessive neurotransmitter stimulation

2. receptor mediated endocytosis (eg. transferrin receptor for iron + LDL receptor)

56
Q

anti-Rh - type of antibody

A

IgG (anti-D) –> opsonization

57
Q

CD21 - normal function

A

receptor of C3b complement

58
Q

palms + soles maculopalular rash after transplantation graft vs host disease

A

graft vs host disease

59
Q

Most frequtnely affected organs by graft vs host disease

A
  1. skin –> palms + soles maculopalular rash (desquamate in severe cases)
  2. GI –> diarhea, intestinal bleeding + abd pain
  3. liver –> abdominal liver function test
    (if it is from liver transplantation, liver is not affected)
60
Q

thimic negative selection - interaction with which cells

A

thymic medullary epithelial cells

+ dendritic cells

61
Q

CD7

A

multi-chain complex marker

62
Q

PPSV in <2 age

A

not immunnogenic because their relatively immature humoral antibody response

63
Q

candida - low T cells vs low neutrophils

A

low T –> superficial candida infection

low neutrophil –> systemic candida infection

64
Q

hyper IgM syndrome - mchanism

A

MC: defective CD40L on Th cells (XR)
Rare: defective CD40 on B cells (AR)

65
Q

cardiolipine is found in

A

inner mitoch membrane

66
Q

lupus anticoagulant - pt/ptt

A

increased PTT and/or PT that is not corrected with 1:1 fresh plasma

67
Q

Bloom syndrome

A

generalized chromosomal instability

68
Q

bronchoalveolar lavage fluid in sarcoidosis - CD4/8 ratio

A

more than 2

69
Q

contact dermatitis - cd4 vs cd8

A

it depends on the etiologic agent

70
Q

similar to SCID but not?

A

congenital HIV

71
Q

Langhans cells?

A

(aka: Pirogov-Langhans cell)

large cells found in granulomatous conditions.

72
Q

IgM - complement activation mechanism

A

IgM is able to activate complement only after antigen binding (conformation alternation)

73
Q

melanocytes - shape?

A

dendritic processes that intercalate between the remaining cells of the epidermis

74
Q

lecthinase (C. perfinges) action

A

phospholipase C –> platelet agregation –> vasocclusion –> ischemic necrosis of affected tissues

75
Q

age for influenza vaccination

A

older than 6

76
Q
  1. HBeAg in pregnancy
  2. management of infants born by HBV othes
  3. infant with HBV from mother - chronicity
A
  1. increases the risk of vertical transmission (to 95%), if HBeAg negative –> only 20%
  2. passively immunized at birth with hepatitis B immun globulin, followed by active immunization with recombinant HBV vaccine
  3. chance of progression to chronicity is 90%
77
Q

poison ivy, oak, sumac - mechanism of contact dermatitis

A

produce urushiol –> hapten –> rash –> often linear streaks as the patients walked in the plants

78
Q

major adaptive immune mechanism agaist influenza virus

A

antibodies against hemaglutin

79
Q

eosinophils mediated defence against parasites

A

antibody-depended cell-mediated cytotoxicity

(IgE or IgG) –> binding –> secretion of ROS + Major basic protein

80
Q

Bare lymphocyte syndrome

A

immunodeficiency resulting from a defect in expression of HLA class II antigens on the surface of antigen presenting cells

81
Q

Fibroblasts - caseating granouloma

A

fibroblast proliferation + collagen production contribute to caseating granuloma formation

82
Q

young people infected with N. meningitis - IgA levels

A

if very high leves of IgA –> increased risk for disseminated disease due to cover of IgG/IgM binding sites by IgA

83
Q

reactive arthritis - skin

A 
keratoderma blennorrhagicum (hyperkeratotic vesicles on palms + soles)
circinate balanitis (superpiginous annular dermatitis of the glans of penis
84
Q

LAD 3?

A

similar to to type 1 but causes severe, recurrent, bactrial infections, delayed separation of the umbilical cord, and bleeding complications (affected beta 3 integrins on platelets)

85
Q

Peneath granular cells

A

small intestine cells

release α-defesin + lysozime –> immune system

86
Q

golimumab

A

anti - tnf a

87
Q

Bortezomib - mechanism of action

A

binds + inhibits the 26S proteasome

In MM, it can facilitate apoptosis by preventing degredation of pro-apoptotic factors

88
Q

diagostic test for chronic granulomatous disease (and explain)

A
  1. Nitroblue tetrazolium: involves adding NB to a sample of patients neutrophis –> normal neutrophils produce ROS that can reduce the yellow NBT to blue formazan
  2. Dihydrorhodamine: production of superode radicals by measuring the conversion of DHR to rhodamine, a green compound detected by flow cytometry
89
Q

Nef and Tat genes

A

both HIV genes:
Tat plays a role in viral replication
Nef decreases expression of MHC class I protein on the surface of infected cells

90
Q

inf α + β against protein syntheses in virus infected cells

A

transcription of antiviral enzymes capable of halting protein synthesis such as RNase L + protein Kinase R (inactivates elF-2, inhibiting translation initiation)
ACTIVE ONLY IN dsRNA virus which form in infected cells

Immunology (10 decks)

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